Healthcare Provider Details

I. General information

NPI: 1740805464
Provider Name (Legal Business Name): ZAHID MAHMOOD DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2020
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 W CARO RD
CARO MI
48723-9686
US

IV. Provider business mailing address

6531 N SEELEY AVE # 1
CHICAGO IL
60645-5511
US

V. Phone/Fax

Practice location:
  • Phone: 989-860-0088
  • Fax:
Mailing address:
  • Phone: 773-971-7321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5101027699
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036.166889
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: